Chickenpox And Pregnancy

Question 1

How should chickenpox exposure in pregnancy be managed?

Answer 1

If any doubt about the mother previously having chickenpox, maternal blood should be urgently checked for varicella antibodies
If the mother is not immune to varicella she should be given VZ immunoglobulin (VZIG) as soon as possible

Question 2

VZIG is effective how many days post exposure?

Answer 2

Up to 10 days

Question 3

If a pregnant women develops chickenpox there is an increased risk of…

Answer 3

Serious chickenpox infection (maternal risk) and fetal varicella syndrome risk

Question 4

The risk of fetal varicella syndrome following maternal varicella exposure is…

Answer 4

Around 1% if occur before 20w gestation

Very small number of cases after this period

Question 5

What features of FVS are there?

Answer 5

Skin scarring
Eye defects - microphthalmia, cataracts 
Limb hypoplasia
Microcephaly
Learning disabilities 
Growth retardation

Question 6

Chickenpox can cause severe maternal disease e.g

Answer 6

Varicella pneumonia

Question 7

Oral aciclovir should be given if…

Answer 7

Pregnant woman is >20w gestation and she presents within 24 hours of rash onset
If woman is less than 20w then aciclovir should be considered with caution